ACOs, other delivery reforms shift job roles at hospitals

Phoenix obstetrician Megan Cheney no longer makes hours of telephone calls on Thursday nights to report routine results of laboratory tests to waiting patients. The calls, however, still get made every week. 

A medical assistant with experience in obstetrics and gynecology now handles calls involving routine findings. That has freed time for Cheney to draft the lectures she delivers twice a week to her medical resident trainees. The shift in responsibilities may be minor, a matter of hours in a lengthy work week. But it is one of many underway at Banner Health, where the drive to cut costs has triggered an extensive overhaul of employees' roles and patient care. 

Labor is the largest expense for health systems, and Banner officials see potential savings in freeing up their highest-paid professionals—doctors, pharmacists, advanced practice nurses, physician assistants—for work only they are qualified to do. “We certainly don't need physicians calling back on routine results,” said Mindy Smith, chief operating officer of the Banner Medical Group. To do that, Banner is delegating new responsibilities across a team of clinical and clerical workers. Not only has that shifted work from doctors to medical assistants, but also from medical assistants to clerical staff, whose numbers will soon grow in Cheney's clinic to accommodate the domino-like transfer of duties.